Friday, March 3, 2000

"One More Arrow In the Quiver"

Report on a presentation to staff and patients of a 12-Step treatment facility

By Marty N.

This morning (1/27/00) Marjorie J and I presented the LifeRing approach to a "doctor's hour" meeting of patients and some staff at the Merritt-Peralta Institute (MPI) in Oakland. The MPI is a unit in Oakland’s privately owned Summit mega-hospital located on Pill Hill in midtown. About 30 persons were present, seated around a long table in the board room. The MPI has a reputation for being a hard-core traditional 12-Step treatment facility. Knowledgeable sources have described it without malice as a Step-Nazi citadel. It is one of the largest inpatient facilities and is, after Kaiser, one of the largest outpatient programs in the S.F. Bay Area.

In the reception area on the fifth floor there is a placard containing the 12 Steps in red letters about 2 inches high; this is framed behind glass in a wood case about three feet by four feet. The frame is bolted to the wall with ¼” thick carriage bolts. You can’t miss it. The literature rack is filled with AA and NA schedules in messy profusion. There is an MPI alumni newsletter that contains nothing but 12-Step homilies.

How, you may ask, did we get invited to present our program to this staff? The bottom line answer is: patient demand. The medical director of the facility told us that they were constantly encountering patients who did not want to have anything to do with the 12-Step program, and he, the director, did not know where to send them or what to do with them. So, if you are ever a patient in a treatment facility and you have problems with the 12-Step approach, be sure to register your concerns. You may not see immediate changes, but the cumulative impact of your pressure over a period of time may eventually create an opening for change, as in this case. There are individual treatment professionals in every facility I have had contact with who, like this physician, are driven by a desire to help the patient, over and above any personal 12-step affiliations, and who realize from daily professional experience that the 12-Step approach just does not cut it for a number of their patients. Patient demand is driving these professionals to look for alternatives. Patient demand combined with staff professionalism is what got us invited to this citadel of traditionalism. As far as I know, we are the first and only non-Step group to ever be invited there.

Our host told us before we began that he did not want to polarize the issue into Us v. Them, and did not want to have the session turn into a debate. He wanted us to be seen as a complement and an adjunct to their traditional program, one more arrow in the quiver, not as a rival or a competitor. This is a situation with which everyone who advocates for a secular alternative has to deal. It’s all a lot of fun to polemicize with faceless dodecamaniacs on the Internet, but when you’re talking to a staff meeting and your objective is to win approval to hold a meeting on the premises, the word is: be positive. Our experience in talking to the Kaiser groups in Oakland over the past three years came in very useful here.

In this case, I began by telling about my own recovery. I said that I had 7 years 3 months and 25 days clean and sober, all of it in SOS/LSR, and had never attended any 12-Step meeting. I described LSR/SOS as a supportive, tool-rich environment where people are encouraged to build their own recovery programs, taking what they need for their individual recovery. Then, by way of example, I outlined my own personal 1-2-3 program (do something every day, go to meetings, use the Sobriety Priority as a decision-making tool) along the lines I’ve written in my story in the Handbook. The audience members could see nothing objectionable in this approach, which is in its secular way quite traditional, and it seemed to reassure them at the outset that we were sound.

Then, I explained the concept of the drunk self and the sober self at war in the user/abuser. By drawing cartoon heads on the whiteboard, I was able to show the small, weak, sober self becoming empowered by interaction and support via the meetings, and becoming dominant within the person. This is a plausible, intuitively correct model of recovery, presented in an entirely positive way without polemics. Only later will some in the audience realize that this simple and sensible recovery model requires no Higher Powers. Like Occam's razor, it has no need of the God hypothesis. I concluded with a few words of gratitude toward the LSR/SOS program for being there for me to get sober in, and with appreciation for my new sober life.

Marjorie then took the floor and told very movingly of finding SOS/LSR on the Internet, and how the sosmail list helped her pull herself out of drinking and isolation and helped her get sober, and how participating in LifeRing positively changed the quality of her life.

We then took questions. The first question was to describe what goes on at an LSR meeting. I read the opening statement for our SF Bay meetings out of the Handbook, and briefly described the check-in format and the topic format, emphasizing our use of crosstalk, and our practice of closing meetings with a round of applause.

I don’t remember all the questions in detail, but one of the next ones was about crosstalk. I said that we felt the process of drunks talking with drunks was central to making the sober place inside us stronger (pointing to the whiteboard and the diagram I had drawn), and for that reason we encouraged crosstalk and allowed it in either all or part of each of our meetings. Marjorie pointed out that sometimes we asked a person whether they wanted crosstalk to their share, so that a person could be protected if they felt crosstalk would threaten them. This set the questioner (a person who introduced himself saying “I’m Joe (or whatever name) and I’m an alcoholic”) grumbling to himself but without a comeback. (You need to know that AA, even though it has made an icon out of “drunks talking to drunks” does not allow crosstalk in its meetings.)

Another question was, “do you have mentors or sponsors?” I said that if a newcomer in our group felt attracted to another person’s recovery program and wanted to learn from them in particular, they were free and encouraged to approach that person and form a closer relationship with them. But we had never formalized these relationships. The reason is partly historical. When AA began, meetings were underground and you had to be invited; the person who brought you was your “sponsor.” But today meetings are publicly announced, so there isn’t any need for this role, really. Besides, I said, formalizing the relationship scares us; sponsors have a lot of power, but there isn’t any exam, or any standards, or licensing board, and that worries us; so we’ve kept mentoring strictly informal. The questioner did not pursue this and seemed satisfied.

One person wanted to know the history. I told briefly of how the founder got sober in AA in 1978 but then felt he had to start on a new foundation, and began SSG, and so on. Another questioner (another one who began “I’m Joe and I’m an alcoholic”) took off on this and asked a very interesting question that I had never heard before. He said, what was it the founder could not handle in AA? What was the thing that made him finally decide to leave?

I said the thing that gave the founder cold sweats and finally made him leave AA was the thought “what if God wants me to drink?” He realized in that case he would have to tell God to go to hell. And when he thought about the implications of that, he realized he had to start a program that was not God-based, but was based on the Sobriety Priority. The questioner took this answer very seriously and did not argue with it.

Someone asked whether we were just for atheists and agnostics. I explained that we were not atheist/agnostic but secular, meaning that people of all faiths and none were welcome, and that neither religion nor anti-religion were business that came up in the meetings. I said that people with very definite religious beliefs felt comfortable in our group because our process did not require them to amend the beliefs they came in with.

The same questioner who had asked about the founder then volunteered that he had attended a couple of our meetings and found that, as far as religion goes, in our program “you get to keep what you have.” I think this is a very good expression.

Another questioner asked, skeptically, “is this some kind of experimental program? Have there been any studies done as to whether it works or not?” I answered that as to studies, there was the 1996 study by Connors and Dermen, a copy of which was included in the presentation packet we put together and handed out. Admittedly, I said, this was not a comparative study with a control group, which was the only way to really find out anything scientifically. But then, scientific studies with control groups had never been done for AA or NA either, except in rare instances and with mixed results. If anyone in this room would like to study our group in a scientific way, I said, I’m sure we would be glad to cooperate; please to talk to me afterward. As for being “experimental,” I said we gladly copped to that, we were still learning and developing and trying things out, and I hoped that we would always be listening and learning and developing, and that if we ever got to the point where we thought we had the final answer on how to get you, you, and you, and everyone in the world sober, we would become obnoxious. (I had sense enough to stop there and take another question.)

A questioner wanted to know about our history locally and our name change, and where did we have meetings. I dealt with the name change very briefly: we got involved in litigation with another group that claimed rights to the name and we lost and the court made us change our name. End of story. As to history, I pointed out that our first local meeting was on March 17, 1988, and this meeting was still going, and in fact Marjorie was the current secretary of it. At this time, we have meetings in the area seven days a week, and you can do “seven in seven” in our organization. This made a strong impression on the group. I pointed out we had meetings at the Kaiser in Oakland, at Kaiser in San Francisco, at Kaiser in Richmond and at Kaiser in San Rafael, as well as at Herrick Hospital in Berkeley. This also seemed to impress, as Kaiser is the biggest chemical dependency outpatient program around here, the implication being that if Kaiser hosted our meetings, we must be OK. Also, I said, at Kaiser Oakland on Saturday morning, the patients have to attend a support group between the hours of 10 and 11, and Kaiser has AA and NA and LifeRing going side by side during this hour, patients’ choice. Several heads nodded approvingly at this concept.

When they ran out of questions, our host thanked us and again said, as he had earlier in introducing us, that he frequently had patients who resisted the 12-Step programs and he did not know what to do with them. He felt that an alternative group would be a useful addition to the program, “one more arrow in the quiver.” That seemed to express a consensus. They gave us a good hand. What happened next was completely unexpected to us. The whole group, patients and staff, linked hands and recited the Serenity Prayer, followed by some kind of rah-rah chant along the lines of “keep coming back, it works if you work it,” like at an AA meeting. We took it in stride.

Several patients and staffers talked with us afterward to express interest and support. The physician who was our host said he was pleased with the way it turned out. He joked that he hoped he still had a job after hosting our talk. He looked relaxed and upbeat. He introduced us to the program coordinator, a younger man, and the two of them agreed in our presence that we should have an evening LifeRing meeting at the facility. They would consult their calendar and get back to me. With cordial shaking of hands and thank-yous, we parted.

We left 15 copies of the Professionals’ Packet and a bundle of meeting schedules. One of the staffers said he would personally see that the schedules got into their literature rack. I will follow up about the meeting. I have been looking for a way to get a meeting at this facility for more than three years. From time to time people who have gone through their program manage to find us, and it’s always the same story: 12-Steps rammed down one’s throat, many patients not happy, looking for an alternative. Hopefully they’ll have one soon.

Credit our member B. for providing a key information link to make this happen. A little before Thanksgiving B. had a major relapse, and managed in one weekend to check himself into, and get thrown out of, both the Herrick crisis unit and the MPI unit. When he sobered up and told the story at a meeting, he happened to mention that he saw the same physician, Dr. C., at both places. That was how I learned that the Dr. C whom I already knew from the Wednesday morning Herrick meeting was also on staff at MPI. I had had no idea. The very next day I buttonholed Dr. C at Herrick and asked him whether we could start a meeting at MPI. I nagged him by phone and by letter over the holidays. Last week finally came the invitation, on five days' notice. We were ready.


P.S. I got the call today (ten days later) that we are invited back for a second presentation, this time to staff only, on 2/24. -- MN.

Edited 3/3/00 MN.